Attachment 4 Past Performance Reference Information.pdf
PDF 352 KB Posted
- Attached to
- Repair and Maintenance Services for Materiel Handling Equipment (MHE) and Commercial Cleaning Equipment
- Solicitation number
- HQC011-21-R-0003
- Issued by
-
Defense Commissary Agency
About this file
This document includes a past performance reference form and details of a federal contract solicitation. The solicitation is for repair and maintenance services for material handling equipment and commercial cleaning equipment at five Defense Commissary Agency locations in Okinawa, Japan. The period of performance is one base year from October 1, 2022 to September 30, 2023, with the possibility of four additional one-year option periods. Services shall be delivered in accordance with the performance work statement. All deliverables will be FOB destination. Offerors must submit completed past performance reference forms with contact information for a minimum of three previous relevant contracts by July 18, 2022 to two Defense Commissary Agency email addresses listed.
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Text version
Offeror Company Name
Offeror POC
POC Phone
POC Email
Name:
Address:
Name:
Phone:
Email:
Name:
Phone:
Email:
Contracting Manager or Contracting Officer Representative (COR)
Contract Number or Account Number:
Description of Work Performed
Total Value (including all option years)
Type (FFP, Cost Reimbursement, IDIQ, etc.)
ATTACHMENT 4
SOLICITATION: HQC011-21-R-0003
Past Performance Reference Information Form Completed form must be emailed no later than
July 18, 2022 Send To: kieko.ishikawa@deca.mil and roger.bessette@deca.mil
Reference No. 1
Contracting Agency or Commercial Company
Contracting Officer or Commercial Agent's
Performance Period (Dates that Review Covers) Base year and number of option years
Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken on all contracts. Include a brief description of any dispute/ claim.
POC Phone
POC Email
Name:
Address:
Name:
Phone:
Email:
Name:
Phone:
Email:
Contracting Manager or Contracting Officer Representative (COR)
Contract Number or Account Number:
Description of Work Performed
Total Value (including all option years)
Type (FFP, Cost Reimbursement, IDIQ, etc.)
ATTACHMENT 4
SOLICITATION: HQC011-21-R-0003
Past Performance Reference Information Form Completed form must be emailed no later than
July 18, 2022 Send To: kieko.ishikawa@deca.mil and roger.bessette@deca.mil
Reference No 2
Contracting Agency or Commercial Company
Contracting Officer or Commercial Agent's
Performance Period (Dates that Review Covers) Base year and number of option years
Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken
POC Phone
POC Email
Name:
Address:
Name:
Phone:
Email:
Name:
Phone:
Email:
Contracting Manager or Contracting Officer Representative (COR)
Contract Number or Account Number:
Description of Work Performed
Total Value (including all option years)
Type (FFP, Cost Reimbursement, IDIQ, etc.)
ATTACHMENT 4
SOLICITATION: HQC011-21-R-0003
Past Performance Reference Information Form Completed form must be emailed no later than
July 18, 2022 Send To: kieko.ishikawa@deca.mil and roger.bessette@deca.mil
Reference No. 3
Contracting Agency or Commercial Company
Contracting Officer or Commercial Agent's
Performance Period (Dates that Review Covers) Base year and number of option years
Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken
POC Phone
POC Email
Name:
Address:
Name:
Phone:
Email:
Name:
Phone:
Email:
Contracting Manager or Contracting Officer Representative (COR)
Contract Number or Account Number:
Description of Work Performed
Total Value (including all option years)
Type (FFP, Cost Reimbursement, IDIQ, etc.)
ATTACHMENT 4
SOLICITATION: HQC011-21-R-0003
Past Performance Reference Information Form Completed form must be emailed no later than
July 18, 2022 Send To: kieko.ishikawa@deca.mil and roger.bessette@deca.mil
Reference No. 4
Contracting Agency or Commercial Company
Contracting Officer or Commercial Agent's
Performance Period (Dates that Review Covers) Base year and number of option years
Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken
POC Phone
POC Email
Name:
Address:
Name:
Phone:
Email:
Name:
Phone:
Email:
Contracting Manager or Contracting Officer Representative (COR)
Contract Number or Account Number:
Description of Work Performed
Total Value (including all option years)
Type (FFP, Cost Reimbursement, IDIQ, etc.)
ATTACHMENT 4
SOLICITATION: HQC011-21-R-0003
Past Performance Reference Information Form Completed form must be emailed no later than
July 18, 2022 Send To: kieko.ishikawa@deca.mil and roger.bessette@deca.mil
Reference No. 5
Contracting Agency or Commercial Company
Contracting Officer or Commercial Agent's
Performance Period (Dates that Review Covers) Base year and number of option years
Problems/Corrective Actions Taken/Outcome (The Offeror shall include information on problems encountered/corrective actions taken
Attachment 5 Past Performance Reference Form Reference 1.pdf
| Offeror Company Name: |
| Offeror POC: |
| POC Phone: |
| POC Email: |
| Agency or Company: |
| Address: |
| Name of Contracting Officer: |
| Phone: |
| Email: |
| Contracting Mgr Name: |
| Phone_2: |
| Email Address: |
| Contract Number or Account Number: |
| Description of Work Performed: |
| Contract Type: |
| Total Value including all option years: |
| Performance Period: |
| ProblemsCorrective Actions TakenOutcome: |
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